1 Baseline information

1.1 Female cohort

Baseline information

Characteristics at baseline index date
Characteristic development
N = 6,929,696
1
validation
N = 2,969,869
1
gender

    2 6,929,696 (100%) 2,969,869 (100%)
age

    Median (5% Centile, Q1, Q3, 95% Centile) 34 (18, 25, 49, 73) 34 (18, 25, 49, 73)
    N Missing (% Missing%) 0 (0%) 0 (0%)
ethnicity

    bangladeshi 43,277 (0.6%) 18,378 (0.6%)
    black african 181,931 (2.6%) 78,495 (2.6%)
    black caribbean 85,845 (1.2%) 36,784 (1.2%)
    chinese 114,966 (1.7%) 49,099 (1.7%)
    indian 184,284 (2.7%) 78,619 (2.6%)
    other asian 151,978 (2.2%) 65,218 (2.2%)
    other ethnic 339,518 (4.9%) 146,198 (4.9%)
    pakistani 98,819 (1.4%) 42,487 (1.4%)
    white 4,910,925 (71%) 2,104,181 (71%)
    Missing 818,153 (12%) 350,410 (12%)
hypertension 590,168 (8.5%) 253,150 (8.5%)
ra 41,340 (0.6%) 17,859 (0.6%)
af 31,866 (0.5%) 13,636 (0.5%)
ckd 48,832 (0.7%) 20,942 (0.7%)
smi 106,151 (1.5%) 45,653 (1.5%)
fhcvd 489,757 (7.1%) 209,389 (7.1%)
migraine 491,209 (7.1%) 210,680 (7.1%)
sle 8,378 (0.1%) 3,473 (0.1%)
diabetes

    Absent 6,764,724 (98%) 2,898,508 (98%)
    Type1 22,967 (0.3%) 10,099 (0.3%)
    Type2 142,005 (2.0%) 61,262 (2.1%)
impotence 1,325 (<0.1%) 568 (<0.1%)
cortico 50,139 (0.7%) 21,508 (0.7%)
antipsy 26,998 (0.4%) 11,768 (0.4%)
smoking

    Non-smoker 3,700,998 (53%) 1,586,524 (53%)
    Ex-smoker 1,350,555 (19%) 577,256 (19%)
    Current 1,303,909 (19%) 560,242 (19%)
    Missing 574,234 (8.3%) 245,847 (8.3%)
statins 223,438 (3.2%) 96,352 (3.2%)
antihypertensives 553,177 (8.0%) 237,712 (8.0%)
copd 55,568 (0.8%) 23,891 (0.8%)
int_dis 21,499 (0.3%) 9,343 (0.3%)
downs 3,470 (<0.1%) 1,396 (<0.1%)
oral_cancer 2,285 (<0.1%) 1,035 (<0.1%)
brain_cancer 1,818 (<0.1%) 785 (<0.1%)
lung_cancer 2,706 (<0.1%) 1,038 (<0.1%)
blood_cancer 13,681 (0.2%) 5,863 (0.2%)
pre_eclampsia 19,431 (0.3%) 8,358 (0.3%)
postnatal_depression 91,692 (1.3%) 39,140 (1.3%)
bmi

    Median (5% Centile, Q1, Q3, 95% Centile) 24.2 (19.1, 21.6, 28.3, 36.6) 24.2 (19.1, 21.6, 28.3, 36.6)
    N Missing (% Missing%) 2,507,999 (36%) 1,075,506 (36%)
sbp

    Median (5% Centile, Q1, Q3, 95% Centile) 120 (99, 110, 131, 150) 120 (99, 110, 131, 150)
    N Missing (% Missing%) 1,430,104 (21%) 612,157 (21%)
sbp_var

    Median (5% Centile, Q1, Q3, 95% Centile) 8.7 (1.0, 5.7, 12.7, 19.9) 8.7 (1.0, 5.6, 12.7, 19.9)
    N Missing (% Missing%) 3,191,936 (46%) 1,367,343 (46%)
cholhdl_ratio

    Median (5% Centile, Q1, Q3, 95% Centile) 3.40 (2.10, 2.80, 4.20, 5.60) 3.40 (2.10, 2.80, 4.20, 5.60)
    N Missing (% Missing%) 5,738,652 (83%) 2,460,544 (83%)
nonhdl

    Median (5% Centile, Q1, Q3, 95% Centile) 3.60 (2.10, 2.90, 4.40, 5.70) 3.60 (2.10, 2.90, 4.40, 5.70)
    N Missing (% Missing%) 5,745,669 (83%) 2,463,590 (83%)
IMD

    Median (5% Centile, Q1, Q3, 95% Centile) 11.0 (2.0, 6.0, 15.0, 19.0) 11.0 (2.0, 6.0, 15.0, 19.0)
    N Missing (% Missing%) 8,544 (0.1%) 3,741 (0.1%)
cholesterol

    Median (5% Centile, Q1, Q3, 95% Centile) 5.20 (3.60, 4.50, 6.00, 7.20) 5.20 (3.60, 4.50, 6.00, 7.20)
    N Missing (% Missing%) 5,505,444 (79%) 2,360,651 (79%)
hdl

    Median (5% Centile, Q1, Q3, 95% Centile) 1.50 (0.99, 1.26, 1.80, 2.38) 1.50 (0.99, 1.26, 1.80, 2.38)
    N Missing (% Missing%) 5,748,636 (83%) 2,464,770 (83%)
ldl

    Median (5% Centile, Q1, Q3, 95% Centile) 3.00 (1.66, 2.40, 3.70, 4.80) 3.00 (1.67, 2.40, 3.70, 4.80)
    N Missing (% Missing%) 5,985,980 (86%) 2,566,826 (86%)
1 n (%)

Outcome incidence rates

total follow up (years) n events rate (per 1000 years) year
3549114 19530 5.502781 2005-01-01
3623014 19314 5.330920 2006-01-01
3693905 19232 5.206414 2007-01-01
3787201 19668 5.193282 2008-01-01
3855245 19658 5.099027 2009-01-01
3914935 19596 5.005447 2010-01-01
3969437 19485 4.908757 2011-01-01
4045228 20074 4.962390 2012-01-01
4079327 19421 4.760835 2013-01-01
4111786 19433 4.726170 2014-01-01
4198558 19709 4.694231 2015-01-01
4321645 19841 4.591076 2016-01-01
4418138 20555 4.652412 2017-01-01
4513019 20766 4.601354 2018-01-01
5256346 25101 4.775371 2019-01-01

1.2 Male cohort

Baseline information

Characteristics at baseline index date
Characteristic development
N = 6,657,587
1
validation
N = 2,853,251
1
gender

    1 6,657,587 (100%) 2,853,251 (100%)
age

    Median (5% Centile, Q1, Q3, 95% Centile) 35 (18, 25, 48, 69) 35 (18, 25, 48, 69)
    N Missing (% Missing%) 0 (0%) 0 (0%)
ethnicity

    bangladeshi 47,739 (0.7%) 20,343 (0.7%)
    black african 161,076 (2.4%) 68,622 (2.4%)
    black caribbean 69,313 (1.0%) 29,520 (1.0%)
    chinese 76,534 (1.1%) 33,081 (1.2%)
    indian 186,961 (2.8%) 80,134 (2.8%)
    other asian 148,388 (2.2%) 63,788 (2.2%)
    other ethnic 297,217 (4.5%) 127,462 (4.5%)
    pakistani 109,090 (1.6%) 46,543 (1.6%)
    white 4,161,907 (63%) 1,783,483 (63%)
    Missing 1,399,362 (21%) 600,275 (21%)
hypertension 491,513 (7.4%) 210,718 (7.4%)
ra 15,948 (0.2%) 6,729 (0.2%)
af 42,997 (0.6%) 18,482 (0.6%)
ckd 34,740 (0.5%) 14,888 (0.5%)
smi 92,766 (1.4%) 39,917 (1.4%)
fhcvd 373,041 (5.6%) 159,804 (5.6%)
migraine 189,737 (2.8%) 81,834 (2.9%)
sle 1,059 (<0.1%) 461 (<0.1%)
diabetes

    Absent 6,457,605 (97%) 2,767,670 (97%)
    Type1 30,724 (0.5%) 12,986 (0.5%)
    Type2 169,258 (2.5%) 72,595 (2.5%)
impotence 264,625 (4.0%) 113,546 (4.0%)
cortico 30,086 (0.5%) 12,980 (0.5%)
antipsy 33,183 (0.5%) 14,445 (0.5%)
smoking

    Non-smoker 2,808,997 (42%) 1,204,336 (42%)
    Ex-smoker 1,218,152 (18%) 522,006 (18%)
    Current 1,533,440 (23%) 657,095 (23%)
    Missing 1,096,998 (16%) 469,814 (16%)
statins 236,194 (3.5%) 100,852 (3.5%)
antihypertensives 439,853 (6.6%) 188,251 (6.6%)
copd 58,969 (0.9%) 25,101 (0.9%)
int_dis 31,114 (0.5%) 13,533 (0.5%)
downs 3,644 (<0.1%) 1,543 (<0.1%)
oral_cancer 4,030 (<0.1%) 1,702 (<0.1%)
brain_cancer 2,165 (<0.1%) 941 (<0.1%)
lung_cancer 2,852 (<0.1%) 1,194 (<0.1%)
blood_cancer 16,121 (0.2%) 6,822 (0.2%)
pre_eclampsia 14 (<0.1%) 6 (<0.1%)
postnatal_depression 230 (<0.1%) 104 (<0.1%)
bmi

    Median (5% Centile, Q1, Q3, 95% Centile) 25.4 (19.8, 22.8, 28.5, 34.5) 25.4 (19.8, 22.8, 28.5, 34.5)
    N Missing (% Missing%) 3,133,025 (47%) 1,341,453 (47%)
sbp

    Median (5% Centile, Q1, Q3, 95% Centile) 130 (105, 120, 139, 155) 130 (105, 120, 139, 155)
    N Missing (% Missing%) 2,781,539 (42%) 1,191,013 (42%)
sbp_var

    Median (5% Centile, Q1, Q3, 95% Centile) 9 (1, 5, 14, 21) 9 (0, 5, 14, 21)
    N Missing (% Missing%) 4,920,835 (74%) 2,109,056 (74%)
cholhdl_ratio

    Median (5% Centile, Q1, Q3, 95% Centile) 4.04 (2.40, 3.29, 5.00, 6.50) 4.03 (2.40, 3.29, 4.96, 6.50)
    N Missing (% Missing%) 5,511,264 (83%) 2,361,129 (83%)
nonhdl

    Median (5% Centile, Q1, Q3, 95% Centile) 3.79 (2.11, 3.05, 4.50, 5.70) 3.78 (2.11, 3.05, 4.50, 5.70)
    N Missing (% Missing%) 5,516,764 (83%) 2,363,442 (83%)
IMD

    Median (5% Centile, Q1, Q3, 95% Centile) 11.0 (2.0, 6.0, 15.0, 19.0) 11.0 (2.0, 6.0, 15.0, 19.0)
    N Missing (% Missing%) 8,251 (0.1%) 3,582 (0.1%)
cholesterol

    Median (5% Centile, Q1, Q3, 95% Centile) 5.10 (3.40, 4.40, 5.80, 7.00) 5.10 (3.40, 4.40, 5.80, 7.00)
    N Missing (% Missing%) 5,296,726 (80%) 2,269,252 (80%)
hdl

    Median (5% Centile, Q1, Q3, 95% Centile) 1.22 (0.80, 1.04, 1.50, 1.95) 1.22 (0.80, 1.04, 1.50, 1.95)
    N Missing (% Missing%) 5,519,844 (83%) 2,364,826 (83%)
ldl

    Median (5% Centile, Q1, Q3, 95% Centile) 3.07 (1.60, 2.40, 3.70, 4.70) 3.06 (1.60, 2.40, 3.70, 4.70)
    N Missing (% Missing%) 5,756,144 (86%) 2,466,236 (86%)
1 n (%)

Outcome incidence rates

total follow up (years) n events rate (per 1000 years) year
3554268 24999 7.033517 2005-01-01
3619813 25113 6.937652 2006-01-01
3683994 24809 6.734267 2007-01-01
3762988 24937 6.626914 2008-01-01
3814630 25500 6.684789 2009-01-01
3863668 25204 6.523335 2010-01-01
3897504 25269 6.483380 2011-01-01
3962134 25887 6.533600 2012-01-01
3975906 25474 6.407093 2013-01-01
4023383 25565 6.354105 2014-01-01
4107558 26005 6.331012 2015-01-01
4228502 26767 6.330137 2016-01-01
4333320 27809 6.417481 2017-01-01
4437280 28048 6.320990 2018-01-01
5180255 33674 6.500452 2019-01-01

1.3 Overall outcome incidence rates

Overall:

Gender total follow up (years) n events rate (per 1000 years)
Male 60445203 395060 6.535837
Female 61336898 301383 4.913568

Primary care only:

Gender total follow up (years) n events rate (per 1000 years)
Male 60665210 299952 4.944382
Female 61540711 221315 3.596237

Secondary care only:

Gender total follow up (years) n events rate (per 1000 years)
Male 60898361 269188 4.420283
Female 61786335 187618 3.036561

ONS death data only:

Gender total follow up (years) n events rate (per 1000 years)
Male 62211142 66633 1.0710782
Female 62597055 52057 0.8316206

2 Convergence plots for imputation

Female

Male

3 Shape of non-linear effects interacted with age

Hazard ratio as age increases, interacted with each of the other predictor variables. The spline for age had knots at 25, 40, 55 and 70.

3.1 Interaction with binary variables

3.2 Interaction with polytomous variables

Female Hazard Ratios

Male Hazard Ratios

3.3 Interaction with continuous variables

These plots show how the hazrd ratio of the variable of interst changes relative to a reference value, for a discrete range of ages. The reference value is 25 for BMI, 120 for SBP, 5 for SBP variability, and 3 for cholesterol/HDL ratio. Plotting from the 2.5th to p7.5th percentile.

Alternatively, I could plot how the hazard ratio comparing two fixed values (say 40 vs 25, 30 vs 25, and 20 vs 25) changes as age increases. This would arguably be more 'similar' to the other plots, but I think less informative.

Female Hazard Ratios

Male Hazard Ratios

3.4 Hazard ratio for age

Hazard ratio is assessed at the mean of all other continuous variables, and the reference value for all categorical variables. the hazard ratio is relative to someone age 40.

4 Model evaluation at baseline (visit 0)

4.1 Calibration plots

4.1.1 Calibration in the entire cohort

Female:

Male:

4.1.2 Calibration by age

Female:

Male:

4.1.3 Calibration by ethnicity

Female:

Male:

4.1.4 Calibration by region

Female:

Male:

4.2 Calibration tables

Female:

N ICI E50 E90
Entire cohort 2969869 0.001 0.000 0.003
White 2383595 0.001 0.000 0.003
Bangladeshi 20838 0.003 0.001 0.005
Black african 89036 0.001 0.001 0.002
Black caribbean 41817 0.002 0.001 0.006
Chinese 56055 0.000 0.000 0.001
Indian 89690 0.001 0.000 0.004
Other asian 74230 0.001 0.001 0.001
Other ethnic 166417 0.001 0.000 0.000
Pakistani 48191 0.001 0.001 0.002
(17,30] 1212938 0.000 0.000 0.001
(30,40] 636504 0.001 0.000 0.001
(40,50] 406103 0.001 0.000 0.003
(50,60] 305530 0.002 0.001 0.003
(60,70] 213948 0.005 0.004 0.008
(70,80] 137794 0.009 0.009 0.011
(80,Inf] 57052 0.007 0.005 0.015
East Midlands 84623 0.001 0.000 0.006
East of England 121992 0.001 0.001 0.003
London 708877 0.001 0.000 0.001
North East 83788 0.002 0.001 0.007
North West 485399 0.005 0.001 0.017
South Central 352873 0.002 0.001 0.005
South East Coast 244682 0.001 0.000 0.001
South West 344630 0.001 0.000 0.002
West Midlands 428709 0.002 0.001 0.003
Yorkshire And The Humber 111098 0.003 0.000 0.010

Male:

N ICI E50 E90
Entire cohort 2969869 0.001 0.000 0.003
White 2383595 0.001 0.000 0.003
Bangladeshi 20838 0.003 0.001 0.005
Black african 89036 0.001 0.001 0.002
Black caribbean 41817 0.002 0.001 0.006
Chinese 56055 0.000 0.000 0.001
Indian 89690 0.001 0.000 0.004
Other asian 74230 0.001 0.001 0.001
Other ethnic 166417 0.001 0.000 0.000
Pakistani 48191 0.001 0.001 0.002
(17,30] 1212938 0.000 0.000 0.001
(30,40] 636504 0.001 0.000 0.001
(40,50] 406103 0.001 0.000 0.003
(50,60] 305530 0.002 0.001 0.003
(60,70] 213948 0.005 0.004 0.008
(70,80] 137794 0.009 0.009 0.011
(80,Inf] 57052 0.007 0.005 0.015
East Midlands 84623 0.001 0.000 0.006
East of England 121992 0.001 0.001 0.003
London 708877 0.001 0.000 0.001
North East 83788 0.002 0.001 0.007
North West 485399 0.005 0.001 0.017
South Central 352873 0.002 0.001 0.005
South East Coast 244682 0.001 0.000 0.001
South West 344630 0.001 0.000 0.002
West Midlands 428709 0.002 0.001 0.003
Yorkshire And The Humber 111098 0.003 0.000 0.010

4.3 Discrimination

4.3.1 Entire cohort

The mean (sd) and median (2.5th - 97.5th percentile range) across the results when validated in each development/validation pair.

Female:

mean (sd) median (p2.5, p97.5) min max
0.87 (0) 0.87 (0.87,0.87) 0.87 0.87

Male:

mean (sd) median (p2.5, p97.5) min max
0.86 (0) 0.86 (0.86,0.86) 0.86 0.86

4.3.2 Across subgroups

Evaluated in one development/validation pair.

Female:

N C_index index_lower index_upper
Entire cohort 2969869 0.874 1.08795e+11 1.244425e+11
white 2383595 0.868 8.68000e-01 8.680000e-01
bangladeshi 20838 0.902 9.01000e-01 9.020000e-01
black african 89036 0.871 8.71000e-01 8.710000e-01
black caribbean 41817 0.858 8.57000e-01 8.580000e-01
chinese 56055 0.918 9.17000e-01 9.180000e-01
indian 89690 0.894 8.94000e-01 8.950000e-01
other asian 74230 0.903 9.03000e-01 9.030000e-01
other ethnic 166417 0.893 8.93000e-01 8.930000e-01
pakistani 48191 0.894 8.94000e-01 8.940000e-01
(17,30] 1212938 0.643 6.43000e-01 6.430000e-01
(30,40] 636504 0.738 7.38000e-01 7.380000e-01
(40,50] 406103 0.731 7.31000e-01 7.310000e-01
(50,60] 305530 0.681 6.81000e-01 6.810000e-01
(60,70] 213948 0.637 6.37000e-01 6.370000e-01
(70,80] 137794 0.603 6.03000e-01 6.030000e-01
(80,Inf] 57052 0.577 5.77000e-01 5.770000e-01
East Midlands 84623 0.886 8.85000e-01 8.860000e-01
East of England 121992 0.872 8.72000e-01 8.720000e-01
London 708877 0.893 8.93000e-01 8.930000e-01
North East 83788 0.864 8.64000e-01 8.640000e-01
North West 485399 0.864 8.64000e-01 8.640000e-01
South Central 352873 0.882 8.82000e-01 8.820000e-01
South East Coast 244682 0.873 8.73000e-01 8.730000e-01
South West 344630 0.868 8.68000e-01 8.680000e-01
West Midlands 428709 0.859 8.59000e-01 8.590000e-01
Yorkshire And The Humber 111098 0.876 8.76000e-01 8.760000e-01

Male:

N C_index index_lower index_upper
Entire cohort 2853251 0.859 1.39642e+11 1.6261e+11
white 2255357 0.850 8.50000e-01 8.5000e-01
bangladeshi 25778 0.893 8.93000e-01 8.9300e-01
black african 87189 0.875 8.75000e-01 8.7600e-01
black caribbean 37750 0.882 8.82000e-01 8.8200e-01
chinese 42249 0.937 9.37000e-01 9.3700e-01
indian 101988 0.886 8.86000e-01 8.8600e-01
other asian 81291 0.892 8.92000e-01 8.9200e-01
other ethnic 162327 0.879 8.79000e-01 8.7900e-01
pakistani 59322 0.893 8.93000e-01 8.9300e-01
(17,30] 1085269 0.702 7.02000e-01 7.0200e-01
(30,40] 667332 0.722 7.22000e-01 7.2200e-01
(40,50] 466242 0.693 6.93000e-01 6.9300e-01
(50,60] 313025 0.650 6.50000e-01 6.5000e-01
(60,70] 192902 0.610 6.10000e-01 6.1100e-01
(70,80] 99173 0.587 5.87000e-01 5.8700e-01
(80,Inf] 29308 0.568 5.68000e-01 5.6800e-01
East Midlands 82136 0.880 8.80000e-01 8.8000e-01
East of England 115336 0.851 8.51000e-01 8.5100e-01
London 669396 0.882 8.82000e-01 8.8200e-01
North East 80533 0.842 8.42000e-01 8.4200e-01
North West 474969 0.850 8.50000e-01 8.5000e-01
South Central 338673 0.859 8.59000e-01 8.5900e-01
South East Coast 232467 0.850 8.50000e-01 8.5000e-01
South West 329698 0.854 8.54000e-01 8.5400e-01
West Midlands 418996 0.845 8.45000e-01 8.4500e-01
Yorkshire And The Humber 107727 0.859 8.58000e-01 8.5900e-01

4.4 Instability plots

These instability pare plotted for 3,000 randomly selected individuals. The variation on the y-axis represents the expected variability in risk if the development cohort was to be re-sampled from the entire population which it represents, and a model was developed in these re-sampled cohorts. Naturally, variation increases as the predicted risk increases. We see a small number of individuals where the variability exceeds that of other individuals at their level of predicted risk. Looking at these individuals highlights them to be those with a higher number of risk factors.

5 Temporal validation of initial risk estimation layer

Follow-up index dates are defined at 1/2/3/4/5 years after baseline. Calibration and discrimination are assessed at 5 and 10 years.

In plots and tables, t_fup = number of days after baseline the index date is defined at, t_eval is denoting whether evaluating 5 or 10 year risk predictions.

5.1 Calibration plots

5.1.1 Female

5.1.2 Male

5.2 Calibration tables

gender t follow-up visit N ICI E50 E90
female 5 1 2455459 0.000 0.000 0.000
female 5 2 2058812 0.001 0.000 0.003
female 5 3 1757932 0.002 0.001 0.004
female 5 4 1532580 0.002 0.001 0.006
female 5 5 1351932 0.003 0.001 0.007
female 10 1 2455459 0.001 0.000 0.002
female 10 2 2058812 0.003 0.001 0.007
female 10 3 1757932 0.003 0.001 0.009
female 10 4 1532580 0.004 0.002 0.011
female 10 5 1351932 0.005 0.002 0.013
male 5 1 2425374 0.001 0.000 0.001
male 5 2 2077642 0.001 0.001 0.003
male 5 3 1793566 0.002 0.001 0.004
male 5 4 1562777 0.002 0.001 0.004
male 5 5 1374424 0.002 0.001 0.004
male 10 1 2425374 0.001 0.001 0.003
male 10 2 2077642 0.003 0.002 0.006
male 10 3 1793566 0.004 0.002 0.008
male 10 4 1562777 0.004 0.003 0.009
male 10 5 1374424 0.005 0.003 0.010

5.3 Discrimination

gender t follow-up visit N C_index index_lower index_upper
female 5 years 1 2455459 0.867 0.867 0.867
female 5 years 2 2058812 0.859 0.859 0.859
female 5 years 3 1757932 0.853 0.853 0.853
female 5 years 4 1532580 0.847 0.847 0.847
female 5 years 5 1351932 0.841 0.841 0.841
female 10 years 1 2455459 0.867 0.867 0.867
female 10 years 2 2058812 0.859 0.859 0.859
female 10 years 3 1757932 0.853 0.853 0.853
female 10 years 4 1532580 0.847 0.847 0.847
female 10 years 5 1351932 0.841 0.841 0.841
male 5 years 1 2425374 0.850 0.850 0.850
male 5 years 2 2077642 0.842 0.842 0.842
male 5 years 3 1793566 0.834 0.834 0.834
male 5 years 4 1562777 0.826 0.826 0.826
male 5 years 5 1374424 0.818 0.818 0.818
male 10 years 1 2425374 0.850 0.850 0.850
male 10 years 2 2077642 0.842 0.842 0.842
male 10 years 3 1793566 0.834 0.834 0.834
male 10 years 4 1562777 0.826 0.826 0.826
male 10 years 5 1374424 0.818 0.818 0.818

6 Temporal validation of intervention layer

Follow-up index dates are defined at 1/2/3/4/5 years after baseline. Calibration and discrimination are assessed at 5 and 10 years. We assess interventional changes in each modifiable risk factor sequentially.

In plots and tables, t_fup = number of days after baseline the index date is defined at, t_eval is denoting whether evaluating 5 or 10 year risk predictions, mfr denotes the modifiable risk factor being evaluated.

6.1 Calibration plots

6.1.1 SBP

6.1.1.1 Female

6.1.1.2 Male

6.1.2 BMI

6.1.2.1 Female

6.1.2.2 Male

6.1.3 Non-HDL cholesterol

6.1.3.1 Female

6.1.3.2 Male

6.1.4 Smoking status

6.1.4.1 Female

6.1.4.2 Male

6.2 Calibration tables

gender t MFR follow-up visit N ICI E50 E90
female 5 systolic blood pressure 1 1968593 0.002 0.000 0.005
female 5 systolic blood pressure 2 1662971 0.003 0.000 0.004
female 5 systolic blood pressure 3 1428062 0.003 0.000 0.004
female 5 systolic blood pressure 4 1250995 0.004 0.000 0.004
female 5 systolic blood pressure 5 1105753 0.004 0.001 0.006
female 5 body mass index 1 1543950 0.001 0.000 0.001
female 5 body mass index 2 1269513 0.001 0.000 0.003
female 5 body mass index 3 1062159 0.002 0.000 0.004
female 5 body mass index 4 909644 0.002 0.001 0.006
female 5 body mass index 5 788406 0.002 0.001 0.007
female 5 non-HDL cholesterol 1 428588 0.004 0.004 0.005
female 5 non-HDL cholesterol 2 366484 0.004 0.003 0.006
female 5 non-HDL cholesterol 3 316919 0.004 0.003 0.008
female 5 non-HDL cholesterol 4 276939 0.004 0.003 0.009
female 5 non-HDL cholesterol 5 241240 0.004 0.003 0.009
female 5 smoking status 1 2255786 0.000 0.000 0.000
female 5 smoking status 2 1891789 0.001 0.000 0.003
female 5 smoking status 3 1614590 0.002 0.001 0.005
female 5 smoking status 4 1406987 0.003 0.001 0.007
female 5 smoking status 5 1239519 0.003 0.001 0.008
female 10 systolic blood pressure 1 1968593 0.004 0.000 0.008
female 10 systolic blood pressure 2 1662971 0.005 0.001 0.007
female 10 systolic blood pressure 3 1428062 0.006 0.001 0.007
female 10 systolic blood pressure 4 1250995 0.006 0.001 0.010
female 10 systolic blood pressure 5 1105753 0.006 0.001 0.013
female 10 body mass index 1 1543950 0.001 0.000 0.002
female 10 body mass index 2 1269513 0.002 0.001 0.006
female 10 body mass index 3 1062159 0.003 0.001 0.009
female 10 body mass index 4 909644 0.004 0.001 0.011
female 10 body mass index 5 788406 0.005 0.001 0.014
female 10 non-HDL cholesterol 1 428588 0.007 0.007 0.010
female 10 non-HDL cholesterol 2 366484 0.008 0.006 0.015
female 10 non-HDL cholesterol 3 316919 0.008 0.006 0.019
female 10 non-HDL cholesterol 4 276939 0.008 0.005 0.019
female 10 non-HDL cholesterol 5 241240 0.008 0.005 0.021
female 10 smoking status 1 2255786 0.001 0.000 0.001
female 10 smoking status 2 1891789 0.003 0.001 0.007
female 10 smoking status 3 1614590 0.004 0.001 0.011
female 10 smoking status 4 1406987 0.005 0.002 0.013
female 10 smoking status 5 1239519 0.006 0.002 0.016
male 5 systolic blood pressure 1 1416229 0.004 0.001 0.008
male 5 systolic blood pressure 2 1215758 0.004 0.001 0.008
male 5 systolic blood pressure 3 1052251 0.005 0.001 0.008
male 5 systolic blood pressure 4 919573 0.005 0.001 0.007
male 5 systolic blood pressure 5 808802 0.006 0.002 0.007
male 5 body mass index 1 1260371 0.001 0.001 0.003
male 5 body mass index 2 1053639 0.001 0.001 0.001
male 5 body mass index 3 885211 0.002 0.001 0.003
male 5 body mass index 4 751650 0.002 0.001 0.004
male 5 body mass index 5 644397 0.002 0.001 0.004
male 5 non-HDL cholesterol 1 415115 0.004 0.005 0.007
male 5 non-HDL cholesterol 2 354341 0.004 0.004 0.005
male 5 non-HDL cholesterol 3 304912 0.004 0.004 0.006
male 5 non-HDL cholesterol 4 264177 0.004 0.004 0.006
male 5 non-HDL cholesterol 5 228701 0.005 0.004 0.007
male 5 smoking status 1 2021227 0.001 0.000 0.002
male 5 smoking status 2 1724289 0.001 0.000 0.002
male 5 smoking status 3 1481106 0.002 0.001 0.003
male 5 smoking status 4 1283919 0.002 0.001 0.004
male 5 smoking status 5 1122313 0.002 0.001 0.005
male 10 systolic blood pressure 1 1416229 0.006 0.001 0.012
male 10 systolic blood pressure 2 1215758 0.007 0.001 0.011
male 10 systolic blood pressure 3 1052251 0.008 0.002 0.012
male 10 systolic blood pressure 4 919573 0.008 0.002 0.015
male 10 systolic blood pressure 5 808802 0.009 0.002 0.018
male 10 body mass index 1 1260371 0.002 0.001 0.004
male 10 body mass index 2 1053639 0.003 0.001 0.004
male 10 body mass index 3 885211 0.004 0.002 0.008
male 10 body mass index 4 751650 0.004 0.002 0.011
male 10 body mass index 5 644397 0.005 0.002 0.011
male 10 non-HDL cholesterol 1 415115 0.007 0.008 0.011
male 10 non-HDL cholesterol 2 354341 0.007 0.007 0.011
male 10 non-HDL cholesterol 3 304912 0.008 0.006 0.016
male 10 non-HDL cholesterol 4 264177 0.008 0.006 0.018
male 10 non-HDL cholesterol 5 228701 0.009 0.006 0.020
male 10 smoking status 1 2021227 0.001 0.001 0.002
male 10 smoking status 2 1724289 0.002 0.001 0.005
male 10 smoking status 3 1481106 0.004 0.002 0.009
male 10 smoking status 4 1283919 0.005 0.003 0.011
male 10 smoking status 5 1122313 0.005 0.003 0.013

6.3 Discrimination

gender t MFR follow-up visit N C_index index_lower index_upper
female 5 years systolic blood pressure 1 1968593 0.857 0.857 0.857
female 5 years systolic blood pressure 2 1662971 0.849 0.849 0.849
female 5 years systolic blood pressure 3 1428062 0.842 0.842 0.842
female 5 years systolic blood pressure 4 1250995 0.837 0.837 0.837
female 5 years systolic blood pressure 5 1105753 0.831 0.831 0.831
female 5 years body mass index 1 1543950 0.868 0.868 0.868
female 5 years body mass index 2 1269513 0.861 0.861 0.861
female 5 years body mass index 3 1062159 0.855 0.855 0.855
female 5 years body mass index 4 909644 0.849 0.849 0.849
female 5 years body mass index 5 788406 0.844 0.844 0.844
female 5 years non-HDL cholesterol 1 428588 0.757 0.757 0.757
female 5 years non-HDL cholesterol 2 366484 0.751 0.751 0.751
female 5 years non-HDL cholesterol 3 316919 0.746 0.746 0.746
female 5 years non-HDL cholesterol 4 276939 0.743 0.743 0.743
female 5 years non-HDL cholesterol 5 241240 0.739 0.738 0.739
female 5 years smoking status 1 2255786 0.865 0.865 0.865
female 5 years smoking status 2 1891789 0.857 0.857 0.857
female 5 years smoking status 3 1614590 0.851 0.851 0.851
female 5 years smoking status 4 1406987 0.845 0.845 0.845
female 5 years smoking status 5 1239519 0.839 0.839 0.839
female 10 years systolic blood pressure 1 1968593 0.858 0.858 0.858
female 10 years systolic blood pressure 2 1662971 0.850 0.850 0.850
female 10 years systolic blood pressure 3 1428062 0.843 0.843 0.843
female 10 years systolic blood pressure 4 1250995 0.838 0.838 0.838
female 10 years systolic blood pressure 5 1105753 0.832 0.832 0.832
female 10 years body mass index 1 1543950 0.868 0.868 0.868
female 10 years body mass index 2 1269513 0.861 0.861 0.861
female 10 years body mass index 3 1062159 0.855 0.855 0.855
female 10 years body mass index 4 909644 0.849 0.849 0.849
female 10 years body mass index 5 788406 0.844 0.844 0.844
female 10 years non-HDL cholesterol 1 428588 0.757 0.757 0.757
female 10 years non-HDL cholesterol 2 366484 0.751 0.751 0.751
female 10 years non-HDL cholesterol 3 316919 0.746 0.746 0.746
female 10 years non-HDL cholesterol 4 276939 0.743 0.743 0.743
female 10 years non-HDL cholesterol 5 241240 0.739 0.739 0.739
female 10 years smoking status 1 2255786 0.865 0.865 0.865
female 10 years smoking status 2 1891789 0.857 0.857 0.857
female 10 years smoking status 3 1614590 0.851 0.851 0.851
female 10 years smoking status 4 1406987 0.845 0.845 0.845
female 10 years smoking status 5 1239519 0.839 0.839 0.839
male 5 years systolic blood pressure 1 1416229 0.816 0.816 0.816
male 5 years systolic blood pressure 2 1215758 0.806 0.806 0.806
male 5 years systolic blood pressure 3 1052251 0.797 0.797 0.797
male 5 years systolic blood pressure 4 919573 0.788 0.788 0.788
male 5 years systolic blood pressure 5 808802 0.779 0.779 0.779
male 5 years body mass index 1 1260371 0.844 0.844 0.844
male 5 years body mass index 2 1053639 0.834 0.834 0.834
male 5 years body mass index 3 885211 0.825 0.825 0.825
male 5 years body mass index 4 751650 0.817 0.817 0.817
male 5 years body mass index 5 644397 0.808 0.808 0.808
male 5 years non-HDL cholesterol 1 415115 0.736 0.736 0.736
male 5 years non-HDL cholesterol 2 354341 0.729 0.729 0.729
male 5 years non-HDL cholesterol 3 304912 0.722 0.722 0.722
male 5 years non-HDL cholesterol 4 264177 0.716 0.716 0.716
male 5 years non-HDL cholesterol 5 228701 0.708 0.708 0.708
male 5 years smoking status 1 2021227 0.843 0.843 0.843
male 5 years smoking status 2 1724289 0.833 0.833 0.833
male 5 years smoking status 3 1481106 0.824 0.824 0.824
male 5 years smoking status 4 1283919 0.816 0.816 0.816
male 5 years smoking status 5 1122313 0.807 0.807 0.807
male 10 years systolic blood pressure 1 1416229 0.816 0.816 0.816
male 10 years systolic blood pressure 2 1215758 0.807 0.807 0.807
male 10 years systolic blood pressure 3 1052251 0.798 0.798 0.798
male 10 years systolic blood pressure 4 919573 0.789 0.789 0.789
male 10 years systolic blood pressure 5 808802 0.781 0.781 0.781
male 10 years body mass index 1 1260371 0.844 0.844 0.844
male 10 years body mass index 2 1053639 0.834 0.834 0.834
male 10 years body mass index 3 885211 0.825 0.825 0.825
male 10 years body mass index 4 751650 0.817 0.817 0.817
male 10 years body mass index 5 644397 0.808 0.808 0.808
male 10 years non-HDL cholesterol 1 415115 0.736 0.736 0.736
male 10 years non-HDL cholesterol 2 354341 0.729 0.729 0.729
male 10 years non-HDL cholesterol 3 304912 0.722 0.722 0.722
male 10 years non-HDL cholesterol 4 264177 0.716 0.716 0.716
male 10 years non-HDL cholesterol 5 228701 0.709 0.709 0.709
male 10 years smoking status 1 2021227 0.843 0.843 0.843
male 10 years smoking status 2 1724289 0.833 0.833 0.833
male 10 years smoking status 3 1481106 0.824 0.824 0.824
male 10 years smoking status 4 1283919 0.816 0.816 0.816
male 10 years smoking status 5 1122313 0.807 0.807 0.807